A5036058743- Acute Lymphoblastic Leukemia research
- Childhood Cancer Survivors' Quality of Life
- Neutropenia and Cancer Infections
- Pharmaceutical studies and practices
- Sepsis Diagnosis and Treatment
- Acute Myeloid Leukemia Research
- Health Systems, Economic Evaluations, Quality of Life
- Ethics in Clinical Research
- Statistical Methods in Clinical Trials
- Lymphoma Diagnosis and Treatment
- Meta-analysis and systematic reviews
- Chronic Lymphocytic Leukemia Research
- Adolescent and Pediatric Healthcare
- Viral-associated cancers and disorders
- Hemoglobinopathies and Related Disorders
- Bacterial Identification and Susceptibility Testing
- Neuroblastoma Research and Treatments
- Blood disorders and treatments
- Virus-based gene therapy research
- Pediatric Pain Management Techniques
- Hematological disorders and diagnostics
- Chronic Myeloid Leukemia Treatments
- CAR-T cell therapy research
- Polyomavirus and related diseases
- Electronic Health Records Systems
Emory University
2016-2025
Children's Healthcare of Atlanta
2018-2025
Aflac (United States)
2019-2025
British Columbia Children's Hospital
2024
University of British Columbia
2024
University of Toronto
2024
Seattle Children's Hospital
2024
Children's Hospital of Philadelphia
2011-2022
Center for Cancer and Blood Disorders
2022
Curtin University
2019
B-cell acute lymphoblastic leukemia (B-cell ALL) is the most common childhood cancer. Despite a high overall cure rate, relapsed ALL remains leading cause of cancer-related death among children. The addition bispecific T-cell engager molecule blinatumomab (an anti-CD19 and anti-CD3 single-chain molecule) to therapy for newly diagnosed standard-risk (as defined by National Cancer Institute) in children may improve outcomes.
Reporting of adverse events (AEs) in clinical trials is critical to understanding treatment safety, but data on AE accuracy are limited. This study sought determine the reporting for pediatric acute myeloid leukemia and test whether an external electronic source can improve reporting.
Abstract Background Adverse events (AEs) on Children's Oncology Group (COG) trials are reported manually by clinical research assistants (CRAs). The Common Terminology Criteria for Events (CTCAE) was developed to provide standardized definitions identifying and grading AEs. CTCAE has expanded significantly over its five versions, but the impact of definitional changes not been examined. Procedure This study compared AE number ascertainment among first four versions using a case vignette....
Abstract Disparities in care, treatment-related toxicity and health-related quality of life (HRQoL) for adolescents young adults (AYAs, aged 15-39 years) with cancer are under-addressed partly because limited collection patient-reported outcomes (PROs) clinical trials (CCTs). The AYA years include key developmental milestones distinct from younger older patients, interrupts attainment critical goals. Lack consensus on a standardized approach to assess HRQoL CCTs has the ability improve...
The optimization of outcomes for pediatric cancer patients relies on the successful advancement supportive care to ease treatment burden and mitigate long-term impacts therapy. Advancing requires research prioritization as well development implementation innovations. Like prevailing theme throughout oncology, there is a clear need personalized or precision approaches that are consistent, evidence-based, guided by clinical practice guidelines. By incorporating technology datasets, we can...
There is little longitudinal information about the type and frequency of harm resulting from medication errors among outpatient children with cancer. We aimed to characterize rates types leukemia lymphoma over 7 months treatment.We recruited taking medications at home for or three pediatric cancer centers. Errors were identified by chart review, in-home observation administration, interviews. Physician reviewers confirmed error (Fleiss' κ = 0.95), 0.82), suggested interventions. Generalized...
Background: Datasets on rare diseases, like pediatric acute myeloid leukemia (AML) and lymphoblastic (ALL), have small sample sizes that hinder machine learning (ML). The objective was to develop an interpretable ML framework elucidate actionable insights from tabular disease datasets. Methods: comprehensive employed optimized data imputation sampling, supervised unsupervised learning, literature-based discovery (LBD). deployed assess treatment-related infection in AML ALL. Results: An...
Summary Despite the importance of adverse event (AE) reporting, AEs are under‐reported on clinical trials. We hypothesized that electronic medical record (EMR) data can ascertain laboratory‐based more accurately than those ascertained manually. EMR 12 for patients enrolled two Children's Oncology Group (COG) trials at one institution were extracted, processed and graded. When compared to gold standard chart data, COG AE report sensitivity positive predictive values (PPV) 0–21·1% 20–100%,...
Abstract Black patients with acute myeloid leukemia (AML) experience higher mortality than White patients. We compared induction mortality, acuity of illness prior to chemotherapy, and insurance type between assess whether presentation mediates the disparity. Within a retrospective cohort 1,122 children AML treated two courses standard chemotherapy 2004 2014 in Pediatric Health Information System (PHIS) database, association race (Black versus White) inpatient during was examined. Intensive...
ABSTRACT Introduction While clinical practice guidelines (CPGs) for pediatric oncology infection prophylaxis and management exist, few data describe actual occurring at centers. Methods An electronic survey querying practices in nontransplant patients was iteratively created by the Children's Oncology Group (COG) Cancer Control Supportive Care Infectious Diseases Subcommittee sent to leaders all COG institutions, limiting each site one response represent their institution. Results The rate...
Abstract Background Human Adenovirus (HAdV) can cause life-threatening illness in pediatric allo-HCT recipients, but studies to define incidence and outcomes of HAdV patients are limited. Use PCR-based surveillance varies by HCT center, part because there no approved HAdV-directed therapies. This study describes the epidemiology infection disease who did not undergo surveillance. Methods An cohort was assembled from July 2018 June 2021 at ten US centers. Patients were followed for 180 days...
ABSTRACT High‐dose methotrexate dosage and infusion durations differ across treatment protocols for pediatric leukemia, lymphoma, osteosarcoma. Supportive care interventions are dependent on a patient's elimination of (MTX). Therefore, it is important to establish the expected MTX protocols. Using modeling simulation real‐world data, we determined concentrations at common time points from start (24, 36, 42, 48, 60, 72 hours) that each patient would reach typical discharge threshold (0.4,...
Although corticosteroids remain a mainstay of treatment for acute lymphoblastic leukemia (ALL), they can cause troublesome neurobehavioral changes during active treatment, especially in young children. We evaluated side effects corticosteroid therapy preschool versus school-age children by obtaining structured reports weekly 1 month.Parents 62 (2-17 years) treated on Dana-Farber Cancer Institute (DFCI) ALL Consortium Protocol 00-01 participated the continuation phase treatment. Patients...
10016 Background: Inotuzumab ozogamicin (InO) is effective in adults and children with relapsed/refractory (R/R) CD22+ B-acute lymphoblastic leukemia (B-ALL). Children’s Oncology Group AALL1732 a phase 3 randomized trial evaluating InO for newly diagnosed patients (pts) high-risk B-ALL. Given known hepatic, hematologic, infectious toxicities, two safety phases were completed. Methods: Pts residual marrow disease < 0.01% by end consolidation are to chemotherapy (Arm A) or plus 2 cycles of...
Cellularization of the Drosophila embryo is process by which a syncytium ∼6000 nuclei subdivided into discrete cells. In order to individualize cells, massive membrane addition needs occur that not fully understood. The exocyst complex required for some, but all, forms exocytosis and plays role in directing vesicles appropriate domains plasma membrane. Sec5 central component this we here report isolation new allele sec5 has temperature-sensitive phenotype. Using allele, investigated whether...
Summary Burkitt lymphoma arising in paediatric post‐solid‐organ transplantation‐Burkitt (PSOT‐BL) is a clinically aggressive malignancy and rare form of post‐transplant lymphoproliferative disorder (PTLD). We evaluated 35 patients diagnosed with PSOT‐BL at 14 medical centres the United States. Median age organ transplantation was 2.0 years (range: 0.1–14) diagnosis 8.0 1–17). All but one patient had late onset (≥2 post‐transplant), median interval from transplant to 4.0 0.4–12). Heart ( n =...
Background A better understanding of drivers treatment costs may help identify effective cost containment strategies and prioritize resources. We aimed to develop a method for estimating inpatient pediatric patients with acute myeloid leukemia (AML) enrolled on NCI-funded Phase III trials, compare between AAML0531 arms (standard chemotherapy ± gemtuzumab ozogamicin (GMTZ)), evaluate primary newly diagnosed AML. Procedure Patients from the trial were matched hospital, sex, dates birth...
Abstract The objective of the Cancer Control and Supportive Care (CCL) Committee in Children's Oncology Group (COG) is to reduce overall morbidity mortality therapy‐related toxicities children, adolescents, young adults with cancer. We have targeted five major domains that cause clinically important toxicity: (i) infections inflammation; (ii) malnutrition metabolic dysfunction; (iii) chemotherapy‐induced nausea vomiting; (iv) neuro‐ oto‐toxicty; (v) patient‐reported outcomes health‐related...
BACKGROUND Pediatric oncology patients are at an increased risk of invasive bacterial infection due to immunosuppression. The such in the absence severe neutropenia (absolute neutrophil count ≥ 500/μL) is not well established and a validated prediction model for blood stream (BSI) offers clinical usefulness. METHODS A 6‐site retrospective external validation was conducted using previously published BSI febrile pediatric without neutropenia: Esbenshade/Vanderbilt (EsVan) model. reduced...
Purpose A cohort of pediatric patients with AML treated at hospitals contributing to the Pediatric Health Information System was used evaluate differences in opioid utilization by sex, age, race, and insurance. Methods Billing data were compute prevalence exposure quantify rates among those exposed opioids as days use per 1000 inpatient days. Multivariable regressions compare prevalence, exposed. Results On average across courses, 95.2% analgesics, 84.7% non-opioid analgesics 77.7% opioids....
Abstract Comparisons of early discharge and outpatient postchemotherapy supportive care in pediatric acute myeloid leukemia ( AML ) patients are limited. We used data from the Pediatric Health Information System on a cohort children treated for newly diagnosed to compare course‐specific mortality resource utilization who were discharged after chemotherapy management during neutropenia relative remained hospitalized. Patients categorized at each course as or standard discharge. Discharges...
Abstract Background Polymerase chain reaction (PCR) respiratory viral panel (RVP) testing is often used in evaluation of pediatric cancer patients with febrile neutropenia (FN), but correlation adverse outcomes has not been well characterized. Procedure A retrospective cohort all children ages 0‐21 years admitted to Children's Healthcare Atlanta for FN from January 2013 June 2016 was identified. Patient demographic and clinical variables such as age, RVP results, length stay (LOS), deaths...
Abstract Background Pediatric Epstein‐Barr virus–negative monomorphic post solid organ transplant lymphoproliferative disorder [EBV(−)M‐PTLD] comprises approximately 10% of M‐PTLD. No large multi‐institutional pediatric‐specific reports on treatment and outcome are available. Methods A retrospective review recipients diagnosed with EBV(−)M‐PTLD aged ≤21 years between 2001 2020 in 12 centers the United States Kingdom was performed, including demographics, staging, treatment, outcomes data....